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PubMed2002

Normal P50 gating in children with autism.

BACKGROUND: An important characteristic of children with autism is their unusual reaction to stimuli, which may be related to problems in the filtering of sensory input. For this reason, sensory filtering was measured in children with autism using the P50 gating paradigm. METHOD: Twelve non-mentally retarded children with autism (i.e., having a DSM-IV diagnosis of either autistic disorder or pervasive developmental disorder not otherwise specified) and 11 healthy control children were tested for their ability to suppress P50, measured at the Cz electrode. RESULTS: No differences were found between the children with autism and the control children with regard to absolute P50 amplitudes and P50 suppression. CONCLUSION: The excitability of the neuronal substrate that causes P50 is normal in children with autism, as are the early, inhibitory processes related to P50 gating. These results distinguish between subjects with autism and subjects with schizophrenia, in whom sensory gating is abnormal.

Acoustic Stimulation↗
PubMed2006

Automatic processing of emotional faces in high-functioning pervasive developmental disorders: An affective priming study.

This study examined automatic processing of emotional faces in individuals with high-functioning Pervasive Developmental Disorders (HFPDD) using an affective priming paradigm. Sixteen participants (HFPDD and matched controls) were presented with happy faces, fearful faces or objects in both subliminal and supraliminal exposure conditions, followed by Japanese ideographs for which the participants provided liking ratings. In the HFPDD group, affective priming was not found in either condition; the control group showed affective priming for both emotional faces under the subliminal condition and only for happy faces under the supraliminal condition. Results suggest that the social deficit in autism may derive in part from a failure in evaluating the emotional significance of emotional faces, a function for which the amygdala plays an important role.

Affect↗
PubMed1998

Autism and tuberous sclerosis.

Autism and pervasive developmental disorders (PDD) are common in tuberous sclerosis (TSC). The frequency of autism is about 25%, with 40-45% of TSC cases meeting criteria for autism or PDD. Among autistic populations, the frequency of TSC is 1-4% and perhaps as high as 8-14% among the subgroup of autistic individuals with a seizure disorder. Mental retardation (MR) and seizures, particularly infantile spasms, are significant risk factors in the development of autism/PDD in TSC; however, neither are sufficient or necessary for the development of these behaviors. The mechanism underlying the association of autism and TSC is as yet unclear but clinical features and neuroimaging investigations suggest that an abnormal TSC gene may directly influence the development of autism rather than it being a secondary effect of seizures or MR. The presence of autism/PDD may arise if the TSC gene mutations occur at critical stages of neural development in neural tissue of brain regions critical in the development of autism.

Autistic Disorder↗
PubMed2007

Behaviour management problems as predictors of psychotropic medication and use of psychiatric services in adults with autism.

We examined behaviour management problems as predictors of psychotropic medication, use of psychiatric consultation and in-patient admission in a group of 66 adults with pervasive developmental disorder (PDD) and intellectual disability (ID) and 99 controls matched in age, gender and level of ID. Overall, people with PDD had higher rates of most DAS behaviour problems and more frequent use of anti-psychotics than matched controls. Logistic regression analyses showed that physical aggression and problems such as pestering staff independently predicted use of anti-psychotics. Physical aggression and overactivity predicted further involvement of psychiatric services. PDD diagnosis predicted admission to an in-patient unit. The results suggest that externalizing problem behaviours in adults with autism can predict type of treatment intervention.

Adult↗
PubMed2006

[Characteristics of juvenile court cases with pervasive developmental disorder].

Forty-eight juvenile delinquency cases, who were sent to a family court between April, 2002 and March, 2005, and diagnosed with Pervasive Developmental Disorder (PDD), were examined regarding the following characteristics: (1) demographic, cognitive and social profiles (sex, age, intellectual development, school register), (2) diagnostic subclasses of PDD, and (3) types (classification), causes, and backgrounds of delinquency. While the PDD group revealed no noticeable differences in the distributions of sex, age, school register status, and intellectual abilities, compared with a general delinquent juvenile population, the PDD group showed a much higher rate of sexual offences and antisocial behaviors based on the confusion due to limited interpersonal abilities. Forty-two (87.5%) were diagnosed with Asperger's disorder, with an IQ within the normal range. In more than half of the cases, offensive conducts occurred in their inappropriate a Hemprs to approach others, caused by the underdevelopment of social abilities. In other cases, the primary handicap and associated symptoms of PDD, as well as the obsessive pursuit of a scientific/experimental interest, played some role in the development of delinquency. In dealing with delinquent cases of juveniles with PDD, it seems very important to keep in mind the characteristics of PDD, and cooperate with professionals and organizations of other fields related to juvenile mental health, such as child psychiatrists, social welfare facilities, and institutions of the Ministry of Justice (juvenile detention home, juvenile training school, and probationary office).

Adolescent↗
PubMed2006

Fragmented visuospatial processing in children with pervasive developmental disorder.

Children diagnosed with Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and Asperger Syndrome (AS) may be characterised by a similar perceptual focus on details as children with autistic disorder (AD). This was tested by analysing their performance in a visuoperceptual task [the Children's Embedded Figure Test (CEFT)] and a graphic reproduction task [the Rey Complex Figure Task (Rey CFT)]. Control groups were children with Tourette Syndrome (TS) and typically developing children. The TS sample performed similarly to the normal control group in both tasks. The CEFT results did not show the expected preference for local processing in children with PDD-NOS. However, the Rey CFT data revealed that the children with this lesser variant of PDD processed visuospatial information in a fragmented way and were deficient in global processing.

Asperger Syndrome↗
PubMed2006

Differences in finger length ratio between males with autism, pervasive developmental disorder-not otherwise specified, ADHD, and anxiety disorders.

Children with autism have a relatively shorter index finger (2D) compared with their ring finger (4D). It is often presumed that the 2D:4D ratio is associated with fetal testosterone levels and that high fetal testosterone levels could play a role in the aetiology of autism. It is unknown whether this effect is specific to autism. In this study, 2D:4D ratios of 144 males aged 6 to 14 years (mean age 9y 1 mo [SD 1y 11 mo]) with psychiatric disorders were compared with those of 96 males aged 6 to 13 years from the general population (mean age 9y 1 mo [SD 1y 10 mo]). Psychiatric disorders were divided into autism/Asperger syndrome (n=24), pervasive developmental disorder-not otherwise specified (PDD-NOS; n=26), attention-deficit-hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD; n=68), and anxiety disorders (n=26). Males with autism/Asperger syndrome (p<0.05) and ADHD/ODD (p<0.05) had significantly lower (though not significantly; p=0.52) ratios than males with an anxiety disorder, and males with autism/Asperger syndrome had lower ratios than those in the comparison group. These results indicated that higher fetal testosterone levels may play a role, not only in the origin of autism, but also in the aetiology of PDD-NOS and of ADHD/ODD. Males with anxiety disorders might have been exposed to lower prenatal testosterone levels.

Adolescent↗
PubMed2003

Compliance with administration procedures of tests for children with pervasive developmental disorders: does it exist?

BACKGROUND: There are no specific tools to evaluate functional performance that accommodate the special needs of children with pervasive developmental disorders (PDD). METHOD: Pediatric occupational therapists in Quebec were surveyed to identify assessments that are currently being used, the modifications made, and the use of results for treatment planning and service recommendations. RESULTS: Results from 59 therapists treating children with PDD indicated that 52 different assessments, both standardized and non-standardized, were used. Standardized tests were used infrequently and were rarely administered without modifications. Equal weight is attributed to the results from standardized and non-standardized tests and clinical observations for the purpose of treatment planning and services. PRACTICE IMPLICATIONS: This study highlights the need for practice parameters that would guide the assessment process and create a consensus among therapists and practice centres.

Child↗
PubMed2007

Multiple complex developmental disorder delineated from PDD-NOS.

The objective of this study was to identify behavioral differences between children with multiple complex developmental disorder (MCDD) and those with pervasive developmental disorder-not otherwise specified (PDD-NOS). Twenty-five children (6-12 years) with MCDD and 86 children with PDD-NOS were compared with respect to psychiatric co-morbidity, psychotic thought problems and social contact problems using the child behavior checklist/4-18, the Dutch version of the diagnostic interview schedule for children-Version IV, the child and adolescent functional assessment scale, and the autism diagnostic observation schedule-generic. MCDD was associated with anxiety disorders, disruptive behavior, and psychotic thought problems. PDD-NOS was associated with deficits in social contact. MCDD differs from autistic disorder, and can also be delineated from PDD-NOS.

Anxiety Disorders↗
PubMed1990

Behavioral effects of Org 2766, a synthetic analog of the adrenocorticotrophic hormone (4-9), in 14 outpatient autistic children.

Fourteen children (12 infantile autism full syndrome present, 2 atypical pervasive developmental disorder) between 5 and 13 years of age participated in a double-blind placebo-controlled cross-over trial. Each child received 20 mg Org 2766 (synthetic analog of ACTH 4-9)/day during 4 weeks, or placebo in a randomly assigned sequence. Drug effects were monitored by ethological playroom observation and by Aberrant Behavior Checklist ratings by parents and teachers. Data of the playroom observation pointed to an activating influence of Org 2766, as revealed by a significant decrease of stereotypic behavior and significant increases in "change toys," "locomote," and "talk." Checklist ratings did not show significant changes. The clinical implications of these findings are discussed.

Adrenocorticotropic Hormone↗
PubMed2006

Management of psychiatric disorders in children and adolescents with atypical antipsychotics: a systematic review of published clinical trials.

We aimed to provide a descriptive review of treatment studies of atypical antipsychotics in paediatric psychiatric disorders. A systematic review of the literature used Medline and EMBASE databases to identify clinical trials of atypical antipsychotics in children and adolescents between 1994 and 2006. Trials were limited to double-blind studies and open-label studies of > or = 8 weeks duration that included > or = 20 patients. Nineteen double-blind and 22 open-label studies were identified. Studies included use of clozapine, olanzapine, quetiapine, risperidone, and ziprasidone in the treatment of disruptive behavioural disorders (DBDs), pervasive developmental disorders (PDDs), tic disorder, psychotic disorders, and mania. These medications generally reduced the severity of a variety of psychiatric symptoms in children and adolescents. Less frequent adverse events included extrapyramidal symptoms, hyperglycaemia and diabetes, and endocrine effects. The review of published scientific data suggests that most of the atypical antipsychotics, excluding clozapine, have a favourable risk/benefit profile and effectively reduce disabling behaviours in paediatric psychiatric patients. While there is a body of evidence published of treatment of DBDs and PDDs, there is a lack of controlled data to guide clinical practice for the use of atypical antipsychotics for paediatric psychotic disorders and bipolar disorder. While there have been studies with duration up to 2 years, no definitive data are available that suggest long-term safety; additional studies are warranted.

Adolescent↗
PubMed2000

Parental report of sleep problems in children with autism.

This research evaluated parent reports of sleep behaviors of four groups of children: those with Autism or Pervasive Developmental Disorders, those with General Mental Retardation alone, those attending Special Education classes (with no MR diagnosis), and a control group of similar aged children without a developmental diagnosis. Diagnostic classification and demographic information were determined through parent report, report of classroom registration, and the Gilliam Autism Rating Scale (Gilliam, 1995). To evaluate sleeping behavior the study used a 28-item, five-factor scale (Behavioral Evaluation of Disorders of Sleep/BEDS; Schreck, 1997/1998) constructed from the diagnostic criteria for childhood sleep disorders found in the International Classification of Sleep Disorders: Diagnostic and Coding Manual (ICSD, American Sleep Disorders Association, 1990). Findings suggest that reports of parents with children with autistic characteristics exhibit expected quantities of sleep, but parent perception of their sleep difficulties and sleep quality is different for children with autism than for children in all other study groups.

Autistic Disorder↗
PubMed1991

Use of medication in pervasive developmental disorders.

Medication does not cure PDD, and its use is generally not indicated. However, neuroleptics like haloperidol or trifluoperazine can be useful in the management of behavioral problems. The most common adverse reaction to their use is extrapyramidal effects. However, if one increases the dose gradually and keeps the total daily dose low, the incidence of extrapyramidal effects is likely to remain quite low. A number of drugs that have been used with PDD children and their effectiveness are reviewed. Guidelines for selecting and using an optimal medication for a given patient are also presented. The need to exercise caution in the use of chemicals with severely dysfunctional children, the etiology of whose pathology continues to remain elusive, is stressed.

Antipsychotic Agents↗
PubMed2002

Treatment of mood lability and explosive rage with minerals and vitamins: two case studies in children.

A micronutrient supplement containing a broad range of dietary minerals and vitamins is being examined for the treatment of mood lability in both adults and children (Kaplan et al. 2001; Popper 2001). During pilot work, two medication-free boys with mood lability and explosive rage were studied in an open-label treatment followed by reversal and retreatment. One child was an 8-year-old with atypical obsessive-compulsive disorder, and the other was a 12-year-old with pervasive developmental delay. Both boys were monitored using the mood and temper items from the Conners Parent Rating Scale, as well as the Child Behavior Checklist. In addition, the boy with atypical obsessive-compulsive disorder was monitored with the child version of the Yale-Brown Obsessive Compulsive Scale. Both boys benefited from the micronutrient supplement when examined in ABAB designs: mood, angry outbursts, and obsessional symptoms improved when initially treated, returned when not taking the supplement, and remitted when the micronutrient supplement was reintroduced. Both boys have been followed and are stable on the nutritional supplement for over 2 years. These cases suggest that mood lability and explosive rage can, in some cases, be managed with a mixture of biologically active minerals and vitamins, without using lithium or other traditional psychopharmacologic agents.

Child↗
PubMed1997

Are deficits in the decoding of affective cues and in mentalizing abilities independent?

It has been hypothesized that deficits in theory of mind (ToM) and emotion recognition abilities in subjects with autisticlike disorders are independent. We examined the relationships between deficits in the various social cognitive domains in children with an autistic disorder (N = 20), in children with a pervasive developmental disorder not otherwise specified (PDDNOS) (N = 20), and in psychiatric control (N = 20) and normal children (N = 20). The clinical groups were matched person-to-person on age and verbal IQ. The clinical children were 8-18 years old, the normal children 8-13 years old. The test battery included tasks for the matching and the context recognition of emotional expressions, and a set of first- and second-order ToM tasks. ToM and emotion recognition functioning proved to be better integrated in the non-PDD children than in the PDD children, but also in the PDD children significant correlations were found between ToM and emotion recognition measures.

Adolescent↗
PubMedDate not supplied

The use of selective serotonin reuptake inhibitors in autism and related disorders.

This paper reviews the published literature on the use of selective serotonin reuptake inhibitors (SSRIs) for the treatment of symptoms associated with autistic disorder and other pervasive developmental disorders (PDDs) in both children and adults. To date, placebocontrolled studies of SSRIs have involved only fluvoxamine (in children and adults) and fluoxetine (in children). Open-label and retrospective studies of all other SSRIs in PDDs have also been published that suggest effectiveness. Despite these positive reports, there continues to be questions about the tolerability and appropriate dosing of SSRIs in children with PDDs. Because of the limited number of placebo-controlled studies, definitive conclusions about the role SSRIs should play in the clinical treatment of children with PDDs cannot be drawn. Larger, placebo-controlled studies of SSRIs are needed to guide clinical treatment.

Adult↗
PubMed1984

Chronic illness: psychosocial effects on siblings--I. Chronically ill boys.

Focusing on the adjustment of the siblings of three groups of male children: with pervasive developmental disability, diabetes and no known chronic illness, the present study failed to support the view that siblings of ill children are uniformly at greater risk for psychosocial impairment. However, several domains were identified in which siblings as well as parents of sick children were more susceptible to adjustment problems, though 'risk' seemed to relate more closely to illness-specific variables than the presence or absence of illness. Several sex differences were found suggesting that same-sexed siblings may be more vulnerable to maladjustment than opposite-sexed pairs. The results are discussed in terms of their implications for investigation and intervention for families with an ill member.

Child↗
PubMed2001

[Behavioral problems in children with specific and pervasive developmental disorders, evaluated with the psychopathology assessment scale (AMDP)].

Children with specific developmental disorders of speech and language have an increased rate of psychiatric disorder compared to children developing normally. Children with early infantile autism show psychopathological symptoms in addition to those that are required for the diagnosis. These are often important in daily dealings with the children. As part of a larger study 4 groups of school age children (21 with normal development, 18 with an expressive language disorder, 21 with a receptive language disorder and 11 children with early infantile autism) were rated according to the psychopathological documentation for children (AMDP) within the assessment situation and according to reports of the behaviour outside. Several items were added to include symptoms that are not rated in the present documentation. Significant differences in the means were found between the group of children with autism and the control group. The children with language disorder showed a high variance which was interpreted as a sign for a heterogeneous group. Several of the added items improve the documentation of psychopathological findings in young school children.

Age Factors↗